Why conscious sedation?
In the newborn period, tongue tie division is a quick, minimally traumatic procedure. As infants grow past 12 weeks of age, they become increasingly aware, stronger, and more difficult to position safely and comfortably for a procedure in the mouth. Performing a comprehensive frenuloplasty in an unsedated infant of three to five months is not possible to the standard required for optimal outcomes.
Conscious sedation allows the procedure to be completed thoroughly, safely, and without distress to the infant. The baby is sedated but breathing independently, monitored throughout by Dr. Roche and our clinical team, and recovers quickly.
What is the difference between conscious sedation and general anaesthesia?
Conscious sedation is a medically controlled state of reduced consciousness in which the infant is relaxed and comfortable but continues to breathe independently and can be roused. It is substantially different from general anaesthesia. Recovery is rapid, the infant can feed within an hour after the procedure, and the risks associated with general anaesthesia in infants are avoided. The procedure is conducted under full monitoring by Dr. Justin Roche and our team.
Who is this service for?
- A tongue tie assessment or division was not possible in the newborn period
- An initial procedure was incomplete and revision is needed in an older infant
- Restriction was identified late and the infant is now past the age for in-office division without sedation
- Another provider has said the baby is too old for treatment or must wait
- A previous division has reattached and the infant is now over 12 weeks
Pre-procedure preparation and post-procedure support
We prepare families thoroughly before the procedure: pre-operative feeding support, bodywork to address jaw and neck tension that may affect the outcome, and a clear explanation of exactly what the sedation involves and what to expect on the day.
Post-procedure, we provide structured feeding rehabilitation and wound care guidance, and our team is available for follow-up support throughout recovery. Our approach: Release Restrictions, Retrain Function, Relieve Tension, is as important here as in any other age group.
The National Tongue Tie Centre was established in 2007 as Ireland's first clinic dedicated entirely to the assessment and treatment of tongue tie. The centre treats over 1,000 patients per year and receives patients from across Ireland and internationally.
Led by Dr. Justin Roche (Consultant Paediatrician, FRCPCH, FRCPI, IBCLC), Kate Roche (Chartered Physiotherapist, IBCLC, Feeding Therapist). Clinics in Clonmel, Co. Tipperary and Naas, Co. Kildare.
Frequently asked questions
Conscious sedation in this age group, administered by an experienced Consultant Paediatrician with appropriate monitoring, carries a very low risk profile. Dr. Justin Roche has an extensive background in paediatric medicine and has developed this protocol specifically for this indication. We can discuss any concerns you may have in full at your assessment appointment.
We will discuss the specific sedation protocol with you fully at your consultation. The medications used are well-established in paediatric practice and the sedation is titrated carefully to achieve the appropriate level of relaxation while maintaining independent breathing. Side effects are uncommon and typically mild and short-lived. Dr. Roche will answer all your questions in detail.
Yes. In most cases feeding can resume shortly after the procedure once the infant is fully alert and the clinical team are satisfied with recovery. Our IBCLCs are available on the day to support the first feed post-procedure and advise on the transition home.
No. Older infant frenuloplasty under conscious sedation allows thorough treatment of restrictions that may not be safely manageable in an unsedated infant of this age. The tongue tie is not too thick nor baby too old to treat; it requires the appropriate approach, which is precisely what this service provides.
The conscious sedation service is provided at our Clonmel, Co. Tipperary clinic, where we have the full clinical infrastructure to support the procedure safely. Consultations and standard infant assessments can be arranged at both our Clonmel and Naas locations.
Yes. Revision frenuloplasty under conscious sedation is one of the most common indications for this service. If your baby had a previous division that reattached or was incomplete and they are now older than 12 weeks, this service is specifically designed for that situation.
Book a comprehensive assessment at the National Tongue Tie Centre. If your baby is between 12 weeks and 6 months and has not been treated, has had an incomplete release, or has reattached, contact us to discuss whether conscious sedation frenuloplasty is the right step. Call us, complete our online enquiry form, or visit www.tonguet.ie. Conscious sedation procedures at our Clonmel, Co. Tipperary clinic.
Frenuloplasty is a surgical procedure. Risks, benefits, and individual expectations will be discussed in full at your assessment appointment before any decision to proceed is made.
